Manager – Billing and Claims at Bliss Healthcare

Bliss Healthcare

  • Kenya
  • Permanent
  • Full-time
  • 16 days ago
Bliss Medical Centre is a leading provider of medical services in East Africa, providing accessible, affordable and quality healthcare services. We are the fastest growing chain of modern outpatient medical services with over 80+ Medical Centres. Our driving force is the desire to see people living healthy for maximum productivity; we bel…Manager – Billing and ClaimsJob Purpose
  • Responsible for overseeing all billing and claims operations across Bliss Healthcare Limited to ensure accurate, timely, and compliant invoice verification, claims submission, recon- ciliation, and reporting.
  • This role drives revenue cycle efficiency, minimizes deduc- tions, ensures adherence to payer requirements, and leads the billing & claims team to achieve set KPIs.
Key Responsibilities
  • Lead and supervise all billing and claims activities to ensure 100% invoice receipt, verification, and error-free claim submission.
  • Oversee invoice checks to confirm:
  • Invoice number matches smart, Slade, or m-Tiba report. Member number matches across reports and invoice. Amount matches report totals. Correct claim form is used.
  • Dates and patient names match across all documents. Ensure 100% reconciliation of all insurance accounts.
  • Monitor and achieve KPI targets for the team
  • 95% account sign-off by revenue.
1% deduction rate. * Monitor timely submissions from unit HQ payer.
  • Ensure all visits are Smarted/LCT and all documents uploaded on Slade.
  • Develop, maintain, and implement billing SOPs in alignment with payer requirements.
  • Provide regular training to team members and medical center staff on scheme changes and claims processes. Ensure communication of pending and queried billings to insurers and relevant teams promptly.
  • Submit accurate and timely reports, including real-time system updates with IT teams.
  • Collaborate with operations, finance, and clinical teams to resolve claim disputes, rejections, and delayed payments. Ensure timely statement generation and submission to insurers.
  • Lead initiatives to improve clean claim rates and reduce processing delays.
  • Any other duties assigned by the supervisor(s).
Job RequirementsMinimum Qualifications
  • Bachelor’s degree in Finance, Accounting, Healthcare Administration, or related field.
Experience
  • Minimum 5 years’ experience in healthcare billing and claims, with at least 2 years in a supervisory role.
  • Strong knowledge of medical billing systems (e.g., Slade, m-Tiba) and payer claim processes.
  • Experience in hospital or clinical revenue cycle management added advantage.
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